Organization
LIVE IN LOVE COMMUNITY SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TERAH SHANTELE THOMAS (EXECUTIVE DIRECTOR)
(757) 300-4192
Entity
Organization
Contact information
Practice address
70 KING GEORGE QUAY, CHESAPEAKE, VA 23325-4771
(757) 300-4192
Mailing address
70 KING GEORGE QUAY, CHESAPEAKE, VA 23325-4771
(757) 300-4192
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2705
VA
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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